Earlier this week the Second Circuit affirmed a lower court’s holding which found that drug manufacturer Pfizer Inc.’s practice of providing copay assistance to Medicare beneficiaries violated the Federal Anti-Kickback Statute (“AKS”).... Read More
Last week, the House of Representatives passed an act to extend Medicare telehealth flexibilities after the conclusion of the Public Health Emergency (“PHE”). The “Advancing Telehealth Beyond COVID–19 Act of 2022” (“Act”) aims to... Read More
As previously reported, Frier Levitt filed suit against the New York Department of Health and the New York State Department of Education on behalf of an independent New York oncology practice in an effort to void the State’s new and legally... Read More
Frier Levitt was recently successful in assisting a New Jersey-based specialty pharmacy with the reversal of a full audit chargeback of over $100,000 plus the additional audit fee. A major PBM had conducted an extensive audit on the pharmacy and... Read More
The Department of Justice ("DOJ") indicted a North Carolina physician assistant last month on criminal charges in a genetic testing scheme that resulted in the submission of more than $10 million in fraudulent claims to Medicare. The indictment... Read More
As Pharmacy Benefit Managers (PBMs) review participation in their retail pharmacy networks, pharmacy providers find themselves at risk of termination over past audit results. We have recently seen a significant increase in a particular PBM... Read More
Pharmacy benefit managers (“PBMs”) audit pharmacies within their network to ensure their contracted pharmacies comply with their contractual obligations as well as applicable state and federal laws. However, PBMs often implement abusive audit... Read More
Frier Levitt recently assisted a California-based independent pharmacy that faced an audit from a major pharmacy benefit manager (“PBM”) by successfully challenging the audit findings and reversing 100% of the purported discrepancies. During... Read More
Pharmacy benefits manager (PBM) Caremark has now placed Trimester 1 Reports for year 2022 in the Caremark Provider Portal. Caremark provides its summaries of Direct and Indirect Remuneration (DIR) Fees paid by participating pharmacy providers for... Read More
On July 20, 2022, the Office of Inspector General (OIG) issued a Special Fraud Alert warning practitioners to exercise caution when entering into certain telehealth arrangements. The Alert references the many recent investigations of telemedicine... Read More
